MEDICARE: DR. JESSE SHAKARIAN D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2112	TN

General Provider Information

NPI Number	:	1831144328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSE SHAKARIAN D.C.

Provider Business Mailing Address
First Line	:	603 HIGHWAY 321 N
Second Line	:	BLDG 3 SUITE 201
City	:	LENOIR CITY
State	:	TN
Zip	:	37771-6575
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	603 HIGHWAY 321 N
Second Line	:	BLDG 3 SUITE 201
City	:	LENOIR CITY
State	:	TN
Zip	:	37771-6575
Country	:	US
Telephone Number	:	865-988-9815
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	07/25/2011

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